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Systemic Lupus Erythematosus with Lupus Nephritis, Community-Acquired Pneumonia, Bilateral Pleural Effusion, Pericardial Effusion, and Hypoalbuminemia in a 20-Year-Old Male Patient: A Case Report Pratama Yudha, Muhammad Agung; Deka Viotra; Najirman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 8 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i8.1050

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammation. Lupus nephritis is a serious complication of SLE that can cause kidney failure. Community acquired pneumonia (CAP), bilateral pleural effusion, pericardial effusion, and hypoalbuminemia are other complications that can occur in SLE patients. Case presentation: We report the case of a 20-year-old man with SLE who presented with lupus nephritis, CAP, bilateral pleural effusion, pericardial effusion, and hypoalbuminemia. Patients were diagnosed with SLE based on the American College of Rheumatology (ACR) classification criteria. The diagnosis of lupus nephritis is made based on the presence of proteinuria, hematuria, and casts on urinalysis, as well as findings on kidney biopsy. CAP is diagnosed based on the presence of fever, cough, cough with phlegm, and infiltrates on chest X-ray. Bilateral pleural effusion and pericardial effusion were diagnosed based on physical examination and findings on chest ultrasound. Hypoalbuminemia is diagnosed based on low serum albumin levels. Patients are treated with steroids, antimalarials, diuretics, and antibiotics. The patient's symptoms improved and complications resolved. Conclusion: SLE is a complex disease that can cause a variety of serious complications. Early diagnosis and treatment of these complications are essential to improve the patient's prognosis. This case shows that SLE can cause a variety of serious complications, including lupus nephritis, CAP, bilateral pleural effusion, pericardial effusion, and hypoalbuminemia. Early diagnosis and treatment of these complications are essential to improve the patient's prognosis.

Behçet's Syndrome Treatment: A Meta-Analysis Comparing Efficacy and Safety of Immunosuppressants and Biologics Herdian Prima Arionata; Najirman; Eka Kurniawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i2.1198

Background: Behçet's syndrome (BS) is a chronic inflammatory disorder characterized by recurrent oral and genital ulcers, uveitis, and skin lesions. Immunosuppressants and biologics are commonly used to manage BS, but their comparative efficacy and safety remain unclear. Methods: A systematic literature search was conducted in PubMed, Embase, and Cochrane Library databases from January 2013 to October 2024. Randomized controlled trials (RCTs) comparing immunosuppressants (azathioprine) and biologics (TNF-alpha inhibitors - infliximab, adalimumab, etanercept) in adult BS patients were included. The primary outcomes were clinical response rates (defined as improvement in disease activity scores) and adverse events. A random-effects model was used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Results: Six RCTs (n=785 patients) met the inclusion criteria. Biologics demonstrated significantly higher clinical response rates compared to immunosuppressants (OR 4.57, 95% CI 3.26-6.40, p<0.00001). Infliximab, adalimumab, and etanercept showed superiority over azathioprine (OR 4.40, 95% CI 2.33-8.30, p<0.00001; OR 5.51, 95% CI 2.86-10.61, p<0.00001; OR 4.19, 95% CI 2.54-6.92, p<0.00001, respectively). Adverse events were comparable between groups, with no significant difference in serious infections or malignancies. Conclusion: Biologics, particularly TNF-alpha inhibitors, are more efficacious than conventional immunosuppressants in inducing clinical response in BS, with similar safety profiles. These findings support the use of biologics as a first-line treatment option for moderate-to-severe BS.

FEBI (Focused Interaction-Based Education) Education Model with Application in Blood Glucose Control in Type 2 Diabetes Mellitus Patients Febriyanti; Masrul; Najirman; Indrapriyatna, Ahmad Syafruddin; Yunir, Em; Mudjiran; Semiarty, Rima; Yulia, Dwi
proceedinginternational Vol. 5 (2025): Proceeding International Conference 15th Desember 2024
Publisher : POLTEKKES KEMENKES PADANG

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33761/jd.v5i.55

Background: Optimal blood glucose control is the main key to preventing complications of type 2 Diabetes Mellitus (DM). However, many patients have difficulty maintaining glycemic control due to limited knowledge, ongoing education and lack of therapeutic interaction. The FEBI Education Model (Focused Interaction-Based Education) is designed to increase patient engagement through an interactive educational approach based on digital applications. Objective: This study was to test the effectiveness of the FEBI Education Model in helping control blood glucose in patients with type 2 DM. Method: The study used a quasi-experimental design with a one-group Pretest-Posttest design approach. With a sample of 30 patients with type 2 DM in the working area of Andalas Health Center and Ambacang Kuranji Health Center, with a purposive sampling technique and data analysis using Paired T-test samples. The FEBI model integrates self-education, glucose monitoring, medication reminders, and online consultative interaction features. The main parameters measured were changes in knowledge and attitudes and glycated albumin levels during one month of intervention. Results: The results of the study showed that there was an increase in knowledge and attitudes with a p-value of 0.00 and a decrease in glycated albumin levels with a -value of 0.025, statistically it can be concluded that there is an influence of the FEBI education model with an increase in knowledge and attitudes and a decrease in glycated albumin levels. Conclusion: The application-based FEBI Education Model is effective in improving blood glucose control in patients with type 2 DM. This interactive approach has the potential to be an innovative strategy in supporting technology-based diabetes management. Keywords: Type 2 Diabetes Mellitus, Interactive Education, Mobile Application, Blood Glucose Control

Understanding Smoking Behavior in Productive-Age Men: A Survey in Padang City Abdiana; Masrul; Hardisman; Najirman
proceedinginternational Vol. 5 (2025): Proceeding International Conference 15th Desember 2024
Publisher : POLTEKKES KEMENKES PADANG

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33761/jd.v5i.56

Smoking is still a public health challenge in Indonesia. Nationally, the percentage of the population who smoke has increased from 28.26% in 2022 to 28.99% in 2024. This trend indicates the consistency of smoking habits in society, especially among the productive age group. Men mostly smoke. This can be detrimental to the health of the smoker himself and can also be detrimental to the health of the surrounding environment. There are three important clinical phases in tobacco addiction, namely, trying, sometimes using, and using every day. The purpose of this study was to determine the factors that influence smoking behavior in male adolescents. The method used in this study was a descriptive research type with a population of all productive-age men in Padang City. Sampling used the cluster random sampling technique with a total of 97 respondents. Data were collected through a structured questionnaire that adopted the Global Youth Tobacco Survey (GYTS) instrument. Data were analyzed with a frequency distribution in the form of a percentage. The results showed that 36.1% started smoking at the age of 13 years, the number of cigarettes smoked per day was 1-10 cigarettes (37.1%), the usual place to smoke in public places (30.9%), smoking when gathering with friends (52.6%), Smoking is fun (47.4%), Smoking helps reduce anxiety/anger/restlessness (49.5%), wanting to smoke in the morning immediately after waking up (33%), Getting cigarettes by buying them yourself (55.7%), and the type of cigarette smoked is filtered (39.2%). These findings will inform targeted interventions to reduce tobacco use and promote healthier lifestyles in economically active communities while increasing labor productivity. Keywords: Keywords: age, number of cigarettes, place of Smoking, type of cigarette

Pathophysiology and Management of Refractory Rheumatoid Arthritis: A Narrative Literature Review Ardanny, Ali; Najirman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 4 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i4.966

Refractory rheumatoid arthritis is rheumatoid arthritis that fails to achieve low levels of disease activity using 2-3 DMARDS treatment and at least one other first-line bDMARD. The definition of refractory action is based on the number of failed DMARDs, the scale of the problem, and risk factors for a refractory disease course. Until now, there has been no further research discussing the pathophysiology of refractory RA, but it is known that TNF-α, IL-6, and IL-1 are the most important mediators that enable cell migration and inflammation in RA. IL-6 in particular, acts directly on neutrophils, which then contribute to inflammation and joint destruction by secreting proteolytic enzymes. The main goal to be achieved in RA is remission, low disease activity and an alternative goal for those who fail to achieve therapy targets. Currently, there are several bDMARD agents that can be used as therapy for refractory RA, namely TNF alfa inhibitors, B cell depletion agents, T cell activity inhibitors, and cytokine inhibitors.

Pathophysiology and Management of Refractory Rheumatoid Arthritis: A Narrative Literature Review Ardanny, Ali; Najirman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 4 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i4.966

Refractory rheumatoid arthritis is rheumatoid arthritis that fails to achieve low levels of disease activity using 2-3 DMARDS treatment and at least one other first-line bDMARD. The definition of refractory action is based on the number of failed DMARDs, the scale of the problem, and risk factors for a refractory disease course. Until now, there has been no further research discussing the pathophysiology of refractory RA, but it is known that TNF-α, IL-6, and IL-1 are the most important mediators that enable cell migration and inflammation in RA. IL-6 in particular, acts directly on neutrophils, which then contribute to inflammation and joint destruction by secreting proteolytic enzymes. The main goal to be achieved in RA is remission, low disease activity and an alternative goal for those who fail to achieve therapy targets. Currently, there are several bDMARD agents that can be used as therapy for refractory RA, namely TNF alfa inhibitors, B cell depletion agents, T cell activity inhibitors, and cytokine inhibitors.

Systemic Lupus Erythematosus with Lupus Nephritis, Community-Acquired Pneumonia, Bilateral Pleural Effusion, Pericardial Effusion, and Hypoalbuminemia in a 20-Year-Old Male Patient: A Case Report Pratama Yudha, Muhammad Agung; Deka Viotra; Najirman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 8 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i8.1050

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammation. Lupus nephritis is a serious complication of SLE that can cause kidney failure. Community acquired pneumonia (CAP), bilateral pleural effusion, pericardial effusion, and hypoalbuminemia are other complications that can occur in SLE patients. Case presentation: We report the case of a 20-year-old man with SLE who presented with lupus nephritis, CAP, bilateral pleural effusion, pericardial effusion, and hypoalbuminemia. Patients were diagnosed with SLE based on the American College of Rheumatology (ACR) classification criteria. The diagnosis of lupus nephritis is made based on the presence of proteinuria, hematuria, and casts on urinalysis, as well as findings on kidney biopsy. CAP is diagnosed based on the presence of fever, cough, cough with phlegm, and infiltrates on chest X-ray. Bilateral pleural effusion and pericardial effusion were diagnosed based on physical examination and findings on chest ultrasound. Hypoalbuminemia is diagnosed based on low serum albumin levels. Patients are treated with steroids, antimalarials, diuretics, and antibiotics. The patient's symptoms improved and complications resolved. Conclusion: SLE is a complex disease that can cause a variety of serious complications. Early diagnosis and treatment of these complications are essential to improve the patient's prognosis. This case shows that SLE can cause a variety of serious complications, including lupus nephritis, CAP, bilateral pleural effusion, pericardial effusion, and hypoalbuminemia. Early diagnosis and treatment of these complications are essential to improve the patient's prognosis.

Behçet's Syndrome Treatment: A Meta-Analysis Comparing Efficacy and Safety of Immunosuppressants and Biologics Herdian Prima Arionata; Najirman; Eka Kurniawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i2.1198

Background: Behçet's syndrome (BS) is a chronic inflammatory disorder characterized by recurrent oral and genital ulcers, uveitis, and skin lesions. Immunosuppressants and biologics are commonly used to manage BS, but their comparative efficacy and safety remain unclear. Methods: A systematic literature search was conducted in PubMed, Embase, and Cochrane Library databases from January 2013 to October 2024. Randomized controlled trials (RCTs) comparing immunosuppressants (azathioprine) and biologics (TNF-alpha inhibitors - infliximab, adalimumab, etanercept) in adult BS patients were included. The primary outcomes were clinical response rates (defined as improvement in disease activity scores) and adverse events. A random-effects model was used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Results: Six RCTs (n=785 patients) met the inclusion criteria. Biologics demonstrated significantly higher clinical response rates compared to immunosuppressants (OR 4.57, 95% CI 3.26-6.40, p<0.00001). Infliximab, adalimumab, and etanercept showed superiority over azathioprine (OR 4.40, 95% CI 2.33-8.30, p<0.00001; OR 5.51, 95% CI 2.86-10.61, p<0.00001; OR 4.19, 95% CI 2.54-6.92, p<0.00001, respectively). Adverse events were comparable between groups, with no significant difference in serious infections or malignancies. Conclusion: Biologics, particularly TNF-alpha inhibitors, are more efficacious than conventional immunosuppressants in inducing clinical response in BS, with similar safety profiles. These findings support the use of biologics as a first-line treatment option for moderate-to-severe BS.

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